Using information obtained from hydrogenosomal and biochemical cytology studies these researchers determined the mode of action of metronidazole (Flagyl) in 1976. Metronidazole is today recognized as the gold standard chemotherapeutic agent for the treatment of anaerobic infections caused by prokaryotes (Clostridium, Bacteroides, Helicobacter) and eukaryotes (Trichomonas, Tritrichomonas, Giardia, Entamoeba). Metronidazole is taken up by diffusion. Once taken up by anaerobes, it is non-enzymatically reduced by reduced ferredoxin which is produced by the action of pyruvate:ferredoxin oxido-reductase. This reduction creates products toxic to the anaerobic cell, and allows for selective accumulation of the drug in anaerobes.

Hydrogenosomes are approximately 1 micrometre in diameter but under stress conditions can reach up to 2 micrometres[6] and are so called because they produce molecular hydrogen.
Like mitochondria, they are bound by distinct double membranes and one has an inner membrane with some cristae-like projections.

Hydrogenosomes have evolved from mitochondria by loss of aerobiosis-related features in several lineages (not all hydrogenosomes are directly related).[7] In most cases, hydrogenosomes are genomeless, though genomes have persisted in some lineages such as Neocallimastix, Trichomonas vaginalis or Tritrichomonas foetus.[8] However, a hydrogenosomal genome has been detected in the cockroach ciliateNyctotherus ovalis,[9] and the stramenopileBlastocystis.

The similarity between Nyctotherus and Blastocystis, which are only distantly related, is believed to be the result of convergent evolution, and calls into question whether there is a clear-cut distinction between mitochondria, hydrogenosomes, and mitosomes (another kind of degenerate mitochondria).[10]

The anaerobic ciliated protozoan Nyctotherus ovalis, found in the hindgut of several species of cockroach, has numerous hydrogenosomes that are intimately associated with endosymbiotic methane-producing archaea, the latter using the hydrogen produced by the hydrogenosomes. The matrix of N. ovalis hydrogenosomes contains ribosome-like particles of the same size as a numerous type of ribosome (70s) of the endosymbiotic methanogenic archaea. This suggested the presence of an organellar genome which was indeed discovered by Akhmanova and later partly sequenced by Boxma.[9][11]

One of the reasons that hydrogenosomes are of interest is because of the light they can cast on how life on earth may have evolved. Most life on earth is single celled, like Bacteria and Archaea. By contrast, plants and animals are made up of many cells. Crucially, each cell of a plant or animal is organised very differently from a bacterial cell. Amongst other things, animal and plant cells (which are special cases of what is known as ‘eukaryotic’ cells) contain mitochondria.

Mitochondria are like power stations for cells: They supply ATP molecules used throughout the cell as a power source by ‘burning’ carbohydrates and other fuels. They produce carbon dioxide and water as waste. To produce ATP, mitochondria require abundant supplies of oxygen.

Some single-celled eukaryotes live in places where oxygen is scarce or non-existent and use hydrogenosomes instead of mitochondria to produce ATP. Mitochondria do not function with little or no oxygen, but hydrogenosomes are able to produce ATP from most of the same fuels without using oxygen. In addition to ordinary carbon dioxide, the distinctive waste product of hydrogenosomes is hydrogen: The hydrogen they produce gives the organelles their name.

Hydrogenosomes are considered to be of scientific interest because comparing them with mitochondria may cast light on how all eukaryotic cells evolved. Hosting mitochondria appears to be a basal or near-basal trait among eukaryotes, the study of hydrogenosomes may shed light on how all multi-celled life developed. For example: Which came first: mitochondria, or hydrogenosomes, or some common ancestor?